Pain management Flashcards
What should physiotherapy undergraduate education on pain include (research)
Make sure the physio is:
Confident to facilitate conversation about pain
Competent to teach, coach or mentor
Able to foster hope and self-efficacy in people experiencing pain
(Thompson et al)
What do we know about pain (how could we explain pain to a patient)
Pain is not just a direct response to injury but a protective mechanism created by the brain.
Pain depends on how the brain interprets a situation and perceived threats
Pain doesn’t always mean tissue damage- it is the brain’s way of keeping us safe.
Exercise and physical activity (research)
Offer a supervised group exercise programme to people ages 16 years and older
Encourage people to remain physically active for longer-term general health benefits.
(NICE guidelines)
Psychological therapy for chronic primary pain (research)
Consider acceptance and commitment therapy (ACT) or cognitive behavioural therapy (CBT) for pain for people aged 16 years and over
(NICE guidelines)
Modalities as treatment for pain (research)
Do not offer any transcutaneous electrical nerve stimulation, ultrasound or interferential therapy
(NICE guidelines)
Pharmacological management for pain (research)
Consider antidepressants after a full discussion of the benefits and harms
(NICE guidelines)
What are some examples of opoids and how do they work?
Codeine, morphine, fentanyl
Work by blocking pain messages in the brain and spinal cord
What are examples of NSAIDs and how do they work?
Ibuprofen, naproxen, aspirin, diclophenac
Work by changing the bodies response to pain and swelling.
Helpful for acute strains and sprains, muscle and joint pains
What is the impact of nocebic language? (research)
Keeffe et al
‘Episode of back pain’ or ‘Non-specific LBP’ reduced need for imaging, surgery, second opinion and higher recovery expectations compared to diagnostic labelling.
What is nociceptive pain?
Everyday pain which triggers nociceptors within the tissues.
A delta fibres- spinal cord- spinal thalamic tract, thalamus- somatosensory cortex
What is Neuropathic pain
Pain caused by damage to the nervous system. Interrupting the normal pathway of pain. Sharp or shooting
What is Radicular pain?
Pain that is felt elsewhere. Pain which travels along a spinal nerve root
What is Referred pain?
Pain that is felt elsewhere- no specific distribution, usually above the knee if from the back.
